Massachusetts BCBS announces delay in MAC anesthesia policy change
January 24, 2024HANK/ACE: Anesthesia Coding Partner
February 22, 2024Sometimes, you need to talk to someone about your anesthesia coding and billing challenges. The ACE team is here to help!
Submit a helpline request online, and our ACE experts will get you an answer.
We aim to answer your question within 24 hours of the next business day. If your question is more complex and requires a longer turnaround, we will let you know when you submit it.
Click here to submit your question.
Q1 Code & Chat: Registration is now open
Join the HANK/ACE team for the Q1 Code & Chat at 12 p.m. Central on March 22, 2024.
Our team of experts will chat with you about updates for 2024 and answer your submitted questions.
Click here to register and submit your questions. This event is open to all in the anesthesia community and is free to attend.
CMS Update: LCD proposed changes for Facet
Joint Interventions for Pain Management
The Centers for Medicare and Medicaid Services are taking public comments on Local Coverage Determination (LCD) changes related to Facet Joint Interventions for Pain Management.
The notice was published last week on the CMS website. Review the proposed LCD changes and submit your comments. There are approximately 30 states scheduled to meet on February 21, and public comment is open through March 23.
BCBS Update:
MAC Anesthesia policy in effect in Vermont
After the excitement of BCBS of Massachusetts releasing and then postponing implementation of a change in policy for Monitored Anesthesia Care (MAC) anesthesia for gastrointestinal endoscopic, bronchoscopic, or interventional pain procedures, the ACE team has learned the policy is already in effect in Vermont.
The change, previously shared with our clients and ACE Alert subscribers on January 17, and delayed the following week, was to be effective January 1, 2024. Specifically, it states:
“The use of monitored anesthesia care is considered NOT MEDICALLY NECESSARY for gastrointestinal endoscopic, bronchoscopic, or interventional pain procedures in patients at low to average risk of complications related to the use of moderate sedation.
Monitoring anesthesia care for routine screening and diagnostic colonoscopy in ASA Class I patients is NOT MEDICALLY NECESSARY.”
The Vermont BCBS policy is very clear about the need to have a reason for anesthesia care. Read the Vermont BCBS policy on MAC anesthesia.
The ACE team encourages the anesthesia community to be on the lookout for state BCBS policy updates.